The priority emergent action for a patient with tension pneumothorax is?

The priority emergent action for a patient with tension pneumothorax is?

• A. Observation
• B. Endotracheal intubation
• C. Needle decompression
• D. Nebulized bronchodilator

Answer: (C)

When air collects under pressure in the chest, it compresses the lung on the affected side and shifts the mediastinum, which quickly impairs venous return to the heart and can cause shock. The priority is to relieve that intrapleural pressure as fast as possible so ventilation and blood flow can resume. Needle decompression is the fastest way to achieve this in an emergent setting. By inserting a large-bore needle into the chest (commonly the second intercostal space at the midclavicular line or the fifth intercostal space at the midaxillary line), air is released immediately, reducing the pressure and stabilizing the patient. After this temporary relief, a definitive chest tube placement is performed to continuously evacuate air and re-expand the lung. Observation is inappropriate because it doesn’t relieve the life‑threatening pressure. Endotracheal intubation isn’t the correct first action here because pushing air into the chest with positive pressure can worsen the tension. Nebulized bronchodilator would not address the underlying cause at all.

When air collects under pressure in the chest, it compresses the lung on the affected side and shifts the mediastinum, which quickly impairs venous return to the heart and can cause shock. The priority is to relieve that intrapleural pressure as fast as possible so ventilation and blood flow can resume.

Needle decompression is the fastest way to achieve this in an emergent setting. By inserting a large-bore needle into the chest (commonly the second intercostal space at the midclavicular line or the fifth intercostal space at the midaxillary line), air is released immediately, reducing the pressure and stabilizing the patient. After this temporary relief, a definitive chest tube placement is performed to continuously evacuate air and re-expand the lung.

Observation is inappropriate because it doesn’t relieve the life‑threatening pressure. Endotracheal intubation isn’t the correct first action here because pushing air into the chest with positive pressure can worsen the tension. Nebulized bronchodilator would not address the underlying cause at all.